Provider Contracting Lead Analyst – Voluntary Out-of-Network Pricing - Cigna Healthcare - Remote

The Cigna Group

11h • Remote

About The Position

We are seeking a detail-oriented Lead Analyst to support the Voluntary Out-of-Network Protection Team. This role focuses on driving accurate, fair, and cost-effective pricing for voluntary out-of-network claims, with expertise in Maximum Reimbursable Charge (MRC), Fair Health pricing, and Medicare-based methodologies.
The Lead Analyst resolves pricing disputes, analyzes claims data, and develops tools and insights that support manual pricing teams and external pricing operations. This role directly impacts affordability for members, consistency for providers, and cost efficiency for clients.

Requirements

• 3–5 years of experience in healthcare analytics, provider pricing, or cost containment.
• Strong knowledge of MRC, Fair Health, and Medicare pricing.
• Advanced analytical skills with proficiency in Excel and reporting tools.
• Ability to manage multiple priorities independently in a production environment.
• Bachelor’s degree preferred or equivalent relevant experience.
• If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Nice To Haves

• Experience with voluntary out-of-network claims and dispute resolution.
• Familiarity with manual pricing workflows and external pricing systems.
• Strong collaboration, communication, and problem-solving skills.

Responsibilities

• Resolve voluntary out-of-network pricing disputes using MRC, Fair Health, and Medicare methodologies.
• Analyze pricing data to identify trends, variances, and improvement opportunities.
• Develop tools, reporting, and insights to support manual and external pricing operations.
• Collaborate with Claims, Call Center, and matrixed teams to improve pricing accuracy and workflows.
• Present clear, actionable findings to internal stakeholders.
• Ensure pricing strategies align with fair reimbursement and cost containment goals.

Benefits

• At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level